Concern over patient records at King’s Mill Hospital

CARE inspectors say King’s Mill Hospital has sorted five of seven problems identified last year - but they still have “major concerns” over the handling of patient records.

Watchdog the Care Quality Commission (CQC) has published the results of a check-up on the hospital it made in October after discovering several areas for improvement in May 2011.

Inspectors say patients “could not be confident that their personal records, including medical records, were held securely and remained confidential”.

Executives at the trust which runs the hospital said they “fully accept” the findings and have already taken action.

In May a routine inspection, made public in July, found the hospital needed to make improvements to meet seven of the commission’s 21 essential standards.

Following the October check-up, made public last week, it is now meeting five, but still failing to reach the grade on patient records and consent to care and treatment.

While re-assessing records procedures in October inspectors noted: “We saw a number of people’s notes left unattended on two wards. Patient notes were not stored in lockable trolleys.”

While patients told them staff kept records safely CQC said: “The comments we received did not support the outcome and we saw examples of information not being stored securely.”

The commission also said it had “moderate concerns” over consent to care and treatment at the hospital, compared to “minor concerns” recorded during the May 2011 inspection.

Inspectors said the right tests were not being consistently done on patients who lacked the capacity to make decisions for themselves.

They concluded while patients were able to give “valid consent to the care and treatment that they received”, patients could not be confident that there were “effective systems in place to ensure that assessments of capacity were undertaken when appropriate to ensure that decisions were being made in the best interests of those patients who had been assessed as lacking capacity to make a specific decision”.

Following changes the hospital was found to be compliant on the five other standards it was told to improve on in May: respecting and involving people who use services, cleanliness and infection control, management of medicines, requirements relating to workers and complaints.

“We recognise and understand the concerns that were raised and, as we have been able to demonstrate in making improvements elsewhere, we do listen to feedback and strive for excellence.

“Our immediate focus will be to ensure that we invest in the training of our staff to support them in delivering the best possible care for our patients and to ensure that they have the necessary resources to do their jobs the best that they can.”

Susan Bowler, executive director of nursing and quality said: “We were really pleased to see that our patients feel their privacy, dignity and independence are respected and that we involve them in the choices of treatments we offer. “I am extremely pleased that the CQC have recognised the number of improvements that we have made and strive to continue.

“We acknowledge that the CQC have seen a few examples of information not being stored as securely as it should be and this is obviously something we are addressing.”

Steps had already been taken to improve the way in which medical records are stored securely, she said.

She added: “We are confident that when the CQC re-assess us we will meet all the essential standards, and more significantly we are committed to achieving this on a consistent basis.”

The hospital is now submitting a report to CQC outlining how it will improve to meet the two remaining standards.